Public Employee Press
Cutting
the high cost of drugs
Q & A on mandatory mail order prescription plan
Every time you use the union’s
mail order prescription program, you save money and the DC 37 Health and
Security Plan saves money. These savings help the Plan keep providing
this and many other benefits.
On Jan. 1, the mail order program became mandatory for all Plan participants
who are prescribed maintenance drugs. With drug use growing as prices
rise constantly, medications consume an ever-larger portion of the Plan’s
overall benefit spending. To help curb escalating expenses, the Plan made
the mail order program mandatory for all members,
retirees and eligible dependents who take long-term medication for chronic
conditions such as heart disease, arthritis, cholesterol and hypertension.
(For short-term medicine like an antibiotic, use a local pharmacy.)
Using this program is simple:
(1) Have your doctor prescribe a 90-day supply (multiply the number taken
daily by 90 days) with one refill for an additional 90 days.
(2) Call the Plan’s Inquiry Unit at 212-815-1531 and request a mail
order brochure and envelope.
(3) Fill out the envelope, insert your prescription and the appropriate
co-pay (by check, money order or credit card) and the medicine will be
mailed to your home.
Call the mail order program at 1-800-233-7139 with any questions about
your medication or co-payment or to use an alternative mailing address,
such as your job or a relative. There is no charge for using the mail
order program. In fact, you save money. You get three months of medication
for the price you would pay for two months’ worth at a retail pharmacy.
Q. Can using CFI save me money?
A. Yes. The mail-order program saves purchasers one-third of the cost
of maintenance drugs at a local pharmacy. By mail, a 90-day supply of
medication costs $6 for generic drugs, $16 for medications on the DC 37
Health and Security Plan’s preferred list and $30 for non-preferred
brand-name drugs. At a pharmacy, generics cost $3 for a 30-day supply
(or $9 for 90 days), preferred list drugs are $8 for 30 days ($24 for
90 days) and non-preferred drugs are $15 for 30 days ($45 for 90 days).
Q. My physician prescribed a new
maintenance medication for me. How must I obtain my medication?
A. When your physician prescribes a new maintenance medication for you,
get two prescriptions: one for a 30-day supply with two refills, and the
second for a 90-day supply, with one refill. Take the 30-day prescription
to your local pharmacy. Two weeks after you obtain the third month’s
supply from the pharmacy, send the second prescription to CFI for a 90-day
supply of the medication.
Q. What if I do not use the mail
program after I get the 3 prescriptions from my local pharmacy?
A. If you do not use CFI to obtain your maintenance medication, the Plan
will not pay its share of the cost of the medication from the pharmacy
for the fourth month, nor will the Plan reimburse you.
Q. Can CFI dispense medications
that need to be refrigerated?
A. Yes. The service will ship medications requiring refrigeration in cold
packs.
Q. Does CFI use easy-open bottle
caps?
A. CFI ships prescriptions with child-resistant safety caps, but it will
provide easy-open caps when requested.
Q. I take a long-term medication
that is considered a PICA drug. What will my co-payment be under the mail
order program?
A. Long-term PICA medications (psychotropic, injectable, chemotherapy
and asthma) can be obtained by mail order.
There are no co-payments for chemotherapy and asthma medications. Psychotropic
and injectable medications have no co-payment for generics and a $12 co-payment
for brand name drugs.
Q. I am taking a medication classified
as a controlled substance. Can I use the mail order program?
A. Please contact CFI, our mail order program, at 1-800 233-7139, to discuss
the best way for you to use this program.
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